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General NPI Number Information
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NPI Number | 1275123192
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Entity Type | Individual
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Provider Name | ASHLEY SHERIDAN LAC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 100 CAMPUS DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1282
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Country | US
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Telephone | 732-617-6210
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Fax |
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Provider Business Mailing Address
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Address Line | 490 IRON BRIDGE RD
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City | FREEHOLD
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State | NJ
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Zip | 07728-2910
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Country | US
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Telephone | 732-690-9790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37AC00545500
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License Number State | NJ
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